JP5004176B2 - Endoscope clip attachment - Google Patents

Description

  The present invention relates to an endoscope clip attachment for attaching a clip for performing hemostasis or the like using an endoscope to a sheath side in preparation for use.

In general, an endoscopic clip device uses a clip placed at the distal end of a sheath that is passed through a treatment instrument guide tube of an endoscope to bite a body tissue by an operation from an operation unit attached to the rear end of the sheath. Can be detained.
Therefore, the clip is configured to be separable with respect to the sheath. Generally, a connection hook that is detachable with respect to a connection portion formed at the rear end portion of the clip is provided on the operation wire passed through the sheath. It is attached to the tip.

Various types of connection hooks have been devised so far to be engaged with and disengaged from the rear end connection part of such a clip. The shape that is biased to the state and whose tip is bent inward has a simple structure, and the connecting and separating operations with the clip are reliably performed and the performance is good.
However, clips are often used at multiple locations in a single case, and once clipping is performed, the sheath is temporarily removed from the treatment instrument guide tube of the endoscope and a new clip is quickly attached to the connection hook. It is necessary to move to the next clipping operation.

Therefore, in the conventional clip holder for an endoscope, a guide groove for guiding the connection hook in the opening / closing direction is formed in a direction perpendicular to the tail portion of the clip storage groove into which the clip is inserted from the head. Is closed along the guide groove so that the connecting hook is connected to the clip (for example, Patent Document 1).
WO2004-82488 FIGS. 32 and 33

However, the above-described clip-to-connecting hook connecting operation requires a small connecting hook with a size of about 1 cm at most to be picked up by a fingertip and placed along a thin guide groove. I can't do it. In particular, when the handling person is not an expert or when wearing sterilized gloves, such fine work becomes very difficult.
The present invention has been made to solve such a problem, and it is extremely easy and reliable to perform the connecting operation between the clip and the connecting hook even for an unskilled person or a person wearing sterile gloves. An object of the present invention is to provide a clip attachment for an endoscope.

  In the endoscope clip fitting of the present invention, a connecting portion that can be engaged with and disengaged from a connecting hook pushed forward from the distal end of the sheath is formed in the vicinity of the rear end, and the front portion is forward due to its own elasticity. A clip storing portion for storing the clip biased in an approximately eight-shaped open state toward the clip in the open state, and a hook guide hole for guiding the connecting hook from the rear to the connecting portion of the clip. As the cross-sectional shape of the hook guide hole moves from the rear end opening side toward the boundary side with the front clip storage part, the direction of the connection hook passed through the hook guide hole is disengaged from the connection part of the clip. It is gradually flattened to correct in the possible orientation.

Note that the direction of the connecting hook formed in a shape in which the hook guide hole is biased toward the front by its own elasticity and is bent inward by being biased in a state of being approximately eight-shaped toward the front. It may be formed in a gradually flattened cross-sectional shape from the rear end opening side toward the boundary side with the front clip storage part so as to correct in a direction in which the connection part can be engaged and disengaged.
Further, the cross-sectional shape of the rear end opening of the hook guide hole may be formed in a circular shape or a substantially elliptical shape, and the connecting hook inserted into the hook guide hole is stopped at a position where it can be freely engaged with and disengaged from the connecting portion of the clip. The stopper part may be formed in the front-end | tip part of a hook guide hole.

  According to the clip holder for an endoscope of the present invention, the cross-sectional shape of the hook guide hole is passed through from the rear end opening side toward the boundary side with the front clip storage part. Those who are not skilled in connecting the clip and the connecting hook, such as those who are unskilled or those who have sterilized gloves, etc., because the hook is gradually flattened to correct the direction of the hook so that it can be disengaged from the connecting part of the clip Even so, it can be carried out very easily and reliably.

Embodiments of the present invention will be specifically described below with reference to the drawings.
As shown in FIG. 1 and FIG. 2, the clip holder for an endoscope is constructed by integrally combining two half-pieces 1 and 1 having the same shape for the convenience of manufacturing. In other words, the clip holder for an endoscope is configured in half. 1 shows only one of the two fixture body halves 1 and 1, and FIG. 2 shows a state in which the two fixture body halves 1 and 1 are combined.

Each fixture body half piece 1 is a molded product made of a plastic material, and an engagement hook 2 and an engagement rod 4 that are formed to project from each fixture body half piece 1 are formed on the counterpart fixture body half piece 1 to be combined. As shown in FIG. 3 and FIG. 4, the two hook body half pieces 1 and 1 are integrally fixed to the hook stopper 3 and the engagement groove 5 thus formed. .
As shown in FIG. 5 and FIG. 6 which are a plan sectional view and a side sectional view of the clip holder for an endoscope, FIG. 1 and the like, and the like, the two fixture body half pieces 1 and 1 are combined. A clip storage portion 6 for storing the clip unit 10 including the clip 11 and the clip tightening ring 12 in a state where the clip 11 is opened is formed at a position near the tip in the clip mounting tool for endoscope. The clip 11 is housed in the clip housing 6 in a natural shape without being elastically deformed.

  The clip 11 is formed of a spring-like metal plate or the like, and is urged by its own elasticity so that the front side is opened in an approximately eight shape toward the front, and the leading end is inward (ie, inward (ie, The connecting portion 11a is bent toward the closing direction, the rear end portion is bent back into a substantially U shape (or may be annular), and the connecting portion 11a is connected to a connecting hook 21 of the clip device 20 described later. It has become. The clip tightening ring 12 is formed of a short metal pipe material, a coil material, or the like, and is fitted on a portion near the latter half of the clip 11, and is moved to a position closer to the front with respect to the clip 11. Is forcibly closed.

  The clip housing portion 6 is formed to be depressed by a half of the thickness of the clip unit 10 from the mating surface of each of the fixture body half pieces 1, 1, and loosely sandwich the clip unit 10 as a whole, and is opened in a substantially eight-letter shape The clip 11 is positioned in a state of being opened forward by a wall surface formed in a shape along the back of the clip 11. The wall surface on the front end side (the left side in the drawing) of the clip storage portion 6 only needs to be formed in a range that does not hinder the closing operation of the clip 11. For example, a fan shape as shown by a two-dot chain line in FIG. It may be.

  Further, as shown in FIGS. 5 and 1, the clip storage portion 6 has a clip pressing piece for pressing the clip 11 lightly from the side perpendicular to the opening / closing direction and holding the clip 11 in that position. 7 protrudes from the wall surface along the back portion of the clip 11 to a position along the side surface of the clip 11. As shown in FIG. 7 which shows a cross section cut along the line AA in FIG. 5, the clip pressing piece 7 has each clip pressing piece 7 so that the clip 11 is elastically held by the two clip pressing pieces 7 and 7. The piece 7 is disposed so as to protrude obliquely from the base. Therefore, the clip 11 is held at a predetermined position in the clip housing 6 without rattling even if a certain level of vibration is applied. If a force of a certain level or larger is applied to close the clip 11, each clip pressing piece 7 is elastically deformed, and the clip 11 moves in the closing direction without great resistance. However, even if such a clip pressing piece 7 is not provided, the clip pressing piece 7 may be omitted as long as the clip unit 10 does not rattle within the clip storage portion 6.

  As shown in FIG. 1 and FIG. 2, the connecting hook 21 of the clip device 20 is urged by its own elasticity to open forward in a substantially eight-letter shape so that the tip is inside (ie, the closing direction). It is formed in a shape bent toward An operation wire 23 is loosely inserted in the elongated flexible sheath 22, and a connection hook attached to the distal end of the operation wire 23 by operating the operation wire 23 or the sheath 22 forward and backward from the proximal end side. 21 can protrude from the tip of the sheath 22.

Further, when the clip device 20 is inserted through the treatment instrument guide tube of the endoscope, an outer tube 24 for closing the clip 11 and keeping it in a narrowed state is sheathed on the sheath 22 so as to be slidable in the longitudinal direction. In addition, an operation portion (not shown) for performing the advance / retreat operation is connected to the proximal end of the sheath 22.
The endoscope clip mounting tool is a hook for guiding the connecting hook 21 detachably engaged with the connecting portion 11a of the clip 11 from the rear toward the connecting portion 11a while being pushed forward from the sheath 22. A guide hole 8 and a mantle tube guide hole 9 for guiding the tip of the mantle tube 24 from the position covering the clip 11 to the front are formed in the mating surface portion of the fixture main body half 1, respectively.

  As the hook guide hole 8 is extracted and illustrated in FIG. 8, the hook guide hole 8 moves from the rear end opening 8 a side toward the front end stopper portion 8 b located at the boundary with the front clip storage portion 6. The connecting hook 21 passed therethrough is gradually formed in a flat cross-sectional shape so as to correct the direction so that the connecting portion 11a of the clip 11 can be engaged and disengaged. The shape of the rear end opening 8a of the hook guide hole 8 is formed in a circular or substantially oval shape that can be inserted without being hooked by the connecting hook 21, and the tip stopper portion 8b side is connected to the clip 11. The connecting hook 21 is formed in a narrow width so that the connecting hook 21 is fitted with little play in a direction orthogonal to the portion 11a.

  As a result, as shown in FIG. 2, when the connection hook 21 of the clip device 20 is inserted into the hook guide hole 8 from the rear end opening 8a side, the tip position of the connection hook 21 is (a), (b). As shown in FIGS. 9A and 9B, as the cross-sectional view of each part is illustrated in FIG. 9, the clip is gradually clipped regardless of the direction of the connecting hook 21 on the rear end opening 8a side. 11 is corrected in a direction orthogonal to the connecting portion 11a.

  Then, as shown in FIG. 10, when the distal end of the connecting hook 21 hits the distal end stopper portion 8b of the hook guide hole 8 and stops, the sheath 22 is moved forward with respect to the operation wire 23 as shown in FIG. By performing an operation of pushing (or pulling the operation wire 23 backward with respect to the sheath 22), the connecting hook 21 gradually enters the sheath 22 and is elastically deformed into a constricted state, and the connecting portion 11a of the clip 11 is deformed. Engaged and connected in the state of being bitten. In this way, the connecting operation between the connecting portion 11a of the clip 11 and the connecting hook 21 of the clip device 20 can be performed very easily and reliably even by an unskilled person or a person wearing sterile gloves.

  Next, as shown in FIG. 12, when the tip of the sheath 22 hits the clip clamping ring 12 of the clip unit 10, it can be seen that the sheath 22 can no longer be pushed in, so that the outer tube 24 is attached. Push forward along the outer tube guide hole 9. The outer tube guide hole 9 is formed so as to pass straight through the endoscope clip fitting to a diameter through which the outer tube 24 is smoothly inserted. However, the shape of the outer tube guide hole 9 does not appear in the portion where the short diameter of the hook guide hole 8 is larger than the diameter of the outer tube guide hole 9. In addition, the most distal portion of the outer tube guide hole 9 only needs to be located in front of the clip storage portion 6 and may not penetrate the endoscope clip attachment.

  As a result, as shown in FIG. 13, the outer tube 24 gradually covers the clip 11 as the outer tube 24 advances, and the clip 11 is elastically deformed into a state where it enters the distal end of the outer tube 24 and is narrowed. As shown in FIG. 14, when the distal end of the outer tube 24 reaches a position ahead of the distal end of the clip 11, the clip 11 is completely stored in a state of being constricted in the outer tube 24.

  In this way, the outer tube 24 can be easily and surely covered on the clip 11 connected to the connection hook 21, and the clip unit 10 for the endoscope in which the clip unit 10 is loaded as an overall operation. After the sheath 22 is pushed in, the operation of pushing the outer tube 24 in the same direction only completes the attachment of the clip unit 10 to the clip device 20, and finally the clip fixture is pulled away from the clip device 20. Good.

  The present invention is not limited to the above-described embodiment. For example, in the operation of covering the clip unit 10 with the outer tube 24, the outer tube 24 is not inserted into the endoscope clip fitting. The clip unit 10 may be carried out while being pulled out (or after being pulled out) from the clip holder for an endoscope.

The perspective view which decomposes | disassembles and shows the clip attachment tool for endoscopes of embodiment of this invention. The perspective view of the clip attachment tool for endoscopes of an embodiment of the invention. The fragmentary sectional view of the clip attachment tool for endoscopes of an embodiment of the invention. The fragmentary sectional view of the clip attachment tool for endoscopes of an embodiment of the invention. The plane sectional view of the clip fixture for endoscopes of an embodiment of the invention. Side surface sectional drawing of the clip attachment tool for endoscopes of embodiment of this invention. Sectional drawing of the state cut | disconnected by the AA in FIG. 5 of the clip attachment tool for endoscopes of embodiment of this invention. The schematic diagram of the hook guide hole of the clip attachment tool for endoscopes of an embodiment of the invention. Sectional drawing which shows the change of the attitude | position when a connection hook is pushed in in the hook guide hole of the clip attachment tool for endoscopes of embodiment of this invention. Side surface sectional drawing which shows the change of the state which a connection hook engages with a clip in the clip holder for endoscopes of embodiment of this invention. Side surface sectional drawing which shows the change of the state by which a connection hook engages with a clip with the clip holder for endoscopes of embodiment of this invention. The plane sectional view showing change of the state where a mantle tube covers a clip by clip holder for endoscopes of an embodiment of the invention. The plane sectional view showing change of the state where a mantle tube covers a clip by clip holder for endoscopes of an embodiment of the invention. The plane sectional view in the state where the attachment of the clip unit to the clip device was completed by the clip attachment for endoscope of the embodiment of the present invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Fixture body half 6 ... Clip accommodating part 8 ... Hook guide hole 8a ... Rear end opening part 8b ... End stopper part 9 ... Outer tube guide hole 10 ... Clip unit 11 ... Clip 11a ... Connection part 12 ... Clip tightening ring 20 ... Clip device 21 ... Connecting hook 22 ... Sheath 24 ... Mantle tube

Claims (4)

A state in which a connecting portion that can freely engage and disengage the connecting hook pushed forward from the front end of the sheath is formed in the vicinity of the rear end, and the front portion is opened in a substantially eight-letter shape toward the front due to its own elasticity. A clip storage section for storing the clip biased by
A hook guide hole for guiding the connecting hook from behind to the connecting portion of the clip is provided;
As the cross-sectional shape of the hook guide hole moves from the rear end opening side to the boundary side with the front clip storage part, the direction of the connection hook passed through the hook guide hole is changed with respect to the connection part of the clip. A clip attachment for an endoscope, characterized in that it is gradually flattened so as to be corrected in a detachable direction.   The endoscope clip attachment tool according to claim 1, wherein the hook guide hole is urged by a self-elasticity so as to be opened in a substantially eight-shape toward the front, and the tip is directed inward. From the rear end opening side to the front side of the boundary with the clip storage part so as to correct the direction of the connecting hook formed in a bent shape so as to be detachable from the connecting part of the clip. Endoscopic clip attachment tool which is gradually formed in a flat cross-sectional shape as it goes.   The endoscope clip mounting tool according to claim 1 or 2, wherein a cross-sectional shape of a rear end opening of the hook guide hole is formed in a circular shape or a substantially elliptical shape.   The endoscope clip attachment tool according to claim 1, 2, or 3, wherein a stopper portion for stopping the connection hook inserted into the hook guide hole at a position detachable from the connection portion of the clip, The clip holder for endoscopes formed in the front-end | tip part of the said hook guide hole.

Images